青年与老年急性心肌梗死发病的季节性特征比较

Seasonal difference in onset of acute myocardial infarction in young and elderly patients

目的比较青年与老年急性心肌梗死(acute myocardial infarction,AMI)发病的临床特征,探讨青年AMI发病有无季节性特点。方法我院收治的81例≤40岁确诊为AMI的青年患者及678例≥50岁确诊为AMI的老年患者入选本研究。AMI发病季节与AMI事件的关系用Logistic回归分析,AMI与冠脉病变程度及冠心病(coronary heart disease,CHD)危险因素的关系用Pearson’s chi-square test。结果青年AMI患者在夏季(6～8月)发病比例明显高于冬季(11～3月)(odds ratio=4.004,P=0.031)。青年组与老年组女性患者相比发病比例明显降低(3.70%vs 35.84%)。青年组单只血管病变发生率明显高于老年组(48.15%vs 36.99%)。结论青年AMI患者发病可能与夏季急性血凝、出汗脱水、吸烟等因素有关。

Objective To investigate whether there is a seasonal difference in the onset of acute myocardial infarction(AMI) in young patients,compared with older patients.Methods The study group comprised 81 young(aged≤40 years) and 678 older(aged≥50 years) patients with AMI from 2004 to 2008.AMI incidence of the season and the relationship with the event were analyzed by Logistic regression.AMI and the extent of coronary artery disease and coronary heart disease risk factors were analyzed by Pearson's chi-square test.Results In young patients,the prevalence of the onset of AMI events was significantly higher in summer(from June to August) than in winter(from November to March)(odds ratio =4.004,P=0.031).The incidence rate in young women decreased significantly compared with that in elderly group(3.70% vs 35.84%).Vascular lesion alone in the young group was significantly higher than that in the elderly group(48.15% vs 36.99%).Hypertension was found in 44.44%,diabetes in 3.7%,elevated serum TC and TG in 29.63% and 48.15%,and smoking history in 74.07% of young patients.Conclusions There is a seasonal difference in the onset of AMI events,with an increase in the prevalence during the summer months in young patients.